High Up Is High Risk

“If it’s high up, it’s high risk” – we say this a lot around here at Nationwide Children’s Hospital to remind parents and caregivers not to leave their infants and children up on high surfaces, like chairs, exam tables or countertops. You may think it’s silly to have to remind someone of that, but we see falls in our hospital all the time from kids toppling off of the stool in an exam room, or an unsecured infant catapulting out of its infant carrier and onto the floor. In fact, falls are the number one cause of non-fatal injuries in children. There was a study done a few years ago looking at falls in birth hospitals (yes, injuries that occurred before these little guys even make it home!). The majority of infant falls that occurred over the 3-year study happened when the parent who was holding the baby fell asleep and then dropped the baby from the rocking chair or hospital bed.

As a pediatrician in the emergency room, let me tell you, I have seen it all. Mom slips on the stairs while carrying baby, a 2-year-old sibling holding baby gets bored and drops baby on the floor, Dad carrying baby in bouncy seat when leg of bouncy seat catches on couch and flips unsecured baby out and onto the floor, babysitter trips over dog while carrying baby, baby topples out of grocery cart, I could go on and on and on! Almost every case is unintentional, but avoidable. Here’s a list of 7 easy ways you keep your kids safe from falls.

Use the safety belt – ALWAYS. If your baby is in a car seat, keep the buckle fastened. More than once I have put one of my babies in the infant carrier for a minute to do something else, covered them with a blanket and then, forgetting the harness wasn’t fastened, picked up the infant carrier. Best rule of thumb – if there’s a buckle, use it! It’s there for a reason. This is not just true for car seats, but high chairs, swings, bouncy seat, strollers, and grocery carts.

Use safety gates. A wall-mounted gate should be placed at the top of a flight of stairs and a pressure-mounted gate can be used at the bottom of the stairs. Get these in place before your baby becomes mobile.

Put your baby back in his/her bed. I know how tired you are during those middle of the night meals, and how tempting it is to snuggle up with your baby. But the safest place for your baby is his own sleep surface, on his back with nothing in the crib. This prevents the baby from falling out of a rocking chair, your bed, off the couch, but also significantly decreases the risk of SIDS and sleep-related death.

Anything higher than the floor is not safe. When your baby is in the infant carrier, bouncy seat or Bumbo, never place it up on counters, chairs or beds. If you do have your baby on an elevated surface, such as a changing table, always keep one hand on the baby – you don’t want the first time they figure out how to roll over to be while your back is turned changing the diaper pail!

Don’t forget about your windows. As your baby gets stronger and more curious you will need to make sure that furniture is not placed under a window where a child may climb up and fall out. Screens will NOT keep a child in, so if you plan to have open windows on the 2nd floor, consider purchasing child safe window guards.

Secure your furniture – heavy furniture such as entertainment centers, bookshelves, dressers and TVs should be secured to the wall using brackets, braces, anchors or wall straps to prevent your child from pulling furniture over on top of them.

Don’t use a baby walker. This recommendation of the American Academy of Pediatrics has been out for several years, but every now and then a baby walker shows up at a garage sale or from someone’s hand-me down closet. There are many alternatives that are much safer for your child, without the risk of falling down the stairs.

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Sarah Denny, MD, FAAP, works as an attending physician in the Section of Emergency Medicine at Nationwide Children’s Hospital and as an Associate Clinical Professor of Pediatrics at The Ohio State University School of Medicine. She is Co-Chair of the Injury, Violence and Poison Prevention for the Ohio Chapter of the American Academy of Pediatrics and serves on the Executive Committee for the Council on Injury, Violence and Poison Prevention for the American Academy of Pediatrics. Her specific areas of interest include bike helmet awareness, safe sleep and legislative advocacy.
Sarah is the mom of three energetic little boys (ages 4, 6 and 8). In her free time, Dr. Denny runs half marathons, loves to travel and is learning to garden.